No Snow Day
I woke up early today, but it was a good sleep night. Mornings these days are about whether I was up a little, a lot or not at all during the night. I started taking Atorvastatin earlier this year even though I have had a long history of low cholesterol. I think it was a belt and suspenders prescription suggested by my new California doctor since statins are about restricting cholesterol production in order to prevent arterial plaque buildup in the heart and in the arteries that serve the brain. After about six months of the stuff, I am inclined to ask my doctor if I can get off of it. When I read up on the side effects, there is a long list of digestive, cerebral and muscular possibilities. At my age, mild digestive distress and occasional confusion are just collateral damage of aging and neither of those two afflictions are noticeably different for me since starting the drug. The thing that is starting to bother me is the fact that I wake up in the night and have all manner of muscle aches. In the summer I thought it might be the added outdoor work of hefting bags of rocks and such here and there. Now that my outdoor work is more supervisory than active physical labor, I am changing my mind. I think the statin s giving me the muscle aches that are getting me up at night. I find I can usually go back to sleep after 30-60 minutes of stretching or just sitting. But up at night on the West Coast usually results in email reading and when you put your brain in gear it is simply harder to soothe yourself back to sleep. Given how the doctor asked if I was “willing” to take a statin, I suspect it is an optional drug for me and I am not particularly inclined to take optional drugs, especially when I can connect a side effect to a minor affliction I am feeling.
I had a conversation with someone yesterday about my friend PJ, who died this week. The subject was collateral damage from long term drug use. I am not talking about drugs really, but rather pharmaceuticals. He was either depressive or bipolar and was on brain chemistry drugs for almost fifty years off and on. At some point his major afflictions became less about his state of mind and more about his state of body. He began about ten years ago to suffer from what is classified as a “rare disorder” and that severely impacted his movement and ability to communicate. I am lucky, I guess, because my muscle aches only seem to come at night and since I can go back to sleep after being prematurely awakened, it really isn’t a big deal. But then again, this is only after taking Atorvastatin for six months. Who knows how it might affect me after six years. I’m not sure I want to take that risk.
One of the notable physical things about PJ was that he had a somewhat collapsed chest since infancy due to some sort of heart condition that was resolved during his first year, but which left him with a very noticeable upper body deformity that seemed to look worse than it was. I must admit than when I heard he had collapsed during a walk and that his heart had stopped to the point of irretrievability, I wondered if it was an eventuality of his congenital heart issue. But as I thought about his growing and cumulative physical debilitation over the last forty years (especially the last ten), I concluded that his collapse was the culmination of the toll taken on his body from all the pharmaceuticals he had been forced to take over the years. It is not that hard as a layman to imagine that a brain chemistry drug would cause motor skill deterioration eventually. And mobility constriction leading to physical deterioration must take a toll on the major bodily systems, none perhaps more than the circulatory system. So, I think maybe I will email my doctor to suggest I stop the statin. I am tempted to say that I am not enamored with living on statin island (As a three year resident of the forgotten borough, I am allowed that play on words).
Today, I emailed Dr. (fill in with an unpronounceable Vietnamese name), who is my physician. I feel very dedicated to her since when I needed a doctor to take me on, she was available. I wasn’t even put off by the receptionist/nurse who asked quite politically incorrectly if I was OK with a female physician. When I said I was, she went on to ask if then I was comfortable with an female Asian physician. Again I said that I was. I figure that poor Dr. (fill in with an unpronounceable Vietnamese name) needs all the help she can get retaining patients with a front-end business development effort like hers. Anyway, the good doctor (or more precisely the medical assistant retained to answer annoying emails like mine for the good doctor) responded that I could certainly cease taking the Atorvastatin whenever I wished and that we would look at my lipid profile in January when I came in for a check-up. Furthermore, she went on to explain that as for the Coronavirus vaccine that is all the rage in the news, it would not be available to someone of my profile until late Spring or early Summer. I didn’t even get to ask if that would be the Pfizer/BioNTech or the Moderna varietal. Both are equally effective per their initial clinical trials, but one is from an established pharmaceutical company that has brought us many of our big and high-margin drugs like Advil (which I take every night) and Viagra (which I have never taken and don’t intend to) and, what is that other one that they produce? Oh, yeah, they are the people who make Lipitor and other Atorvastatins. Meanwhile, Moderna is a biotech start-up that has never yet launched a drug of any kind into the market.
Both vaccines that have been approved deploy messenger RNA (mRNA), something we already have in plentiful supply in our bodies. And these vaccines also contain those little fatty materials called lipids. So, I will be giving up a Pfizer product that reduces lipids and at the same time hoping for a vaccine that contains added lipids as the means for defeating the Coronavirus. Pfizer and Moderna both deliver those added lipids into our systems in quite different ways. I’m no biochemist, but I’m thinking that stopping Atorvastatin now will be a good preparation for maximizing the impact of the lipid delivery system of whichever vaccine I am fortunate enough to get. The one thing I know about lipids from years of hearing about them from St. Lukes, Pritikin and Duke (not to mention an array of general practitioners) is that there are good lipids and bad lipids. High-density (HDL) is the good stuff that reduces plaque while Low-density (LDL) is the bad stuff. So, here am I, wondering, when presented with the opportunity by Dr. (fill in with an unpronounceable Vietnamese name) to get my COVID vaccine, if I should pretend to understand the difference in lipid delivery systems between Pfizer and Moderna and even whether the lipids being delivered to me are High or Low density sorts.
In a word, I am confused. But then COVID is confusing in so many ways. Today my granddaughter was upset that she did not get a snow day from Mayor Bill DeBlasio. Virtual education, like remote working has the benefit of eliminating commutation and all the things like meteorological constraints. But still, kids will be kids and no one wants no snow days in life. And I guess I want all good lipids, no bad lipids and a bunch of messenger RNA to keep me from the jaws of the COVID dragon and so that I too do not collapse during an evening walk and have my heart stop from either too much bad cholesterol, too little good cholesterol, lack of sleep or some COVID-induced blood clot that plugs up against the plaque build up in my heart. I just want a snow day like everyone else.